INTRODUCTION
Knowledge about plants and their medicinal properties, as well as their use for the purpose of treating and curing diseases, is one of the oldest forms of medicinal practice in world¹. Since antiquity, myths, legends, and traditions perpetuate the use of medicinal plants and reflect their vast employment in medicine over time².
Although the global market for pharmaceuticals has been predominantly dominated by synthetically derived products³, in recent years, there has been an increased investment in the search for alternative medicines and in the therapeutic use of naturally sourced products, particularly plant derivatives4. The use of herbal medicines in developed countries constitutes an alternative therapy², however many users believe that because they are naturally sourced, medicinal plants pose no threat to the user’s health and are unfortunately unaware that herbal medicines can induce serious adverse effects5. In this study, we highlight a plant with significant medical potential,Hypericum perforatum L., an herbaceous, perennial commonly found in Europe, Asia, Brazil, and the USA6, where it is commonly known as St. John’s wort7. Although,H.perforatum is composed of more than 150 compounds with additive, synergistic, and partially antagonistic properties8, with the most characteristic of the plant’s constituents being naftodiantrones (hypericin and pseudohypercicine), floroglucinols (hyperforin), flavonoids, bioflavonoids, and xanthones9. This diversity of medicinally active components and potential utilization e in the treatment of diverse pathologies has sparked significant interest in the medicinal potential of H. perforatum.
The action mechanisms of H. perforatum have yet to be fully described due to the large abundance and diversity of compounds contained within the plant. Traditional schools of thought have suggested that hypericin was the main active ingredient in H. perforatum extracts. However, studies have shown that hyperforin is found in concentrations higher than that of hypericin within the plant8 and that hyperforin may be primarily responsible for the antidepressant properties attributed to the plant9.
Therefore the use of H. perforatum extracts have become popular due to the plants’ beneficial effects on the nervous system7. H. perforatum has been used for decades in clinical practice specifically in the treatment of a range of mood disorders, presenting significant efficacy in the treatment of acute, mild to moderate depression9,10,11,12. However, although it has a higher safety profile when compared to conventional antidepressants, H. perfuratum is not exempt from adverse reactions and drug interactions9,13,14. Some adverse side effects attributed to H. perfuratum are gastrointestinal symptoms, allergies, dizziness, mental confusion, fatigue, dry mouth and sedation, however these side effects from the use of H. perforatum considered to be mild, moderate or transient in nature15. Additionally, important interactions are reported with conventional synthetic drugs such as diazepam and paracetamol6, antihistamines (fexofenadine), cardiovascular drugs (warfarin), hypolipidemic like simvastatin, gastrointestinal drugs (omeprazole and loperamide), in addition to oral contraceptives, corticosteroids, opioids, antineoplastics, and immunosuppressants8.
Considering these aspects, it is important for the health professionals to have in-depth the appropriate knowledge of phytotherapeutics, specifically their interactions and adverse effects, before administering such medicine or conducting a study on the use of these treatments. Among the health professional, pharmacists have a key role in the process of the use of medicine once he is the last link between the prescription and the use of medicine by patients. According to the American Society of Health-System Pharmacists (ASHP), the mission of a pharmacist is to provide pharmaceutical care, which is defined as the direct, responsible provision of medication-related care for the purpose of achieving definite outcomes that improve a patient’s quality of life16. Therefore, it is of worth importance to develop a study of the use of medicine focused on the knowledge aboutH. perfuratum of pharmacists from public and private pharmacy services-dispensing this herbal medicine